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Clinical outcomes in relapsed oropharyngeal cancer after definitive (chemo)radiotherapy

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Francesca De Felice, Thomas Bird, Andriana Michaelidou, Jean-Pierre Jeannon, Ricard Simo, Richard Oakley, Andrew Lyons, Alastair Fry, Luke Cascarini, Arora Asit, Selvam Thavaraj, Miguel Reis Ferreira, Imran Petkar, Anthony Kong, Mary Lei, Teresa Guerrero Urbano

Original languageEnglish
JournalOral Diseases
DOIs
E-pub ahead of print27 Aug 2021

Bibliographical note

Publisher Copyright: © 2021 Wiley Periodicals LLC

King's Authors

Abstract

Objectives: To report clinical outcomes of relapsed oropharyngeal squamous cell carcinoma (OPSCC) after definitive intensity-modulated (chemo)radiotherapy [(C)RT]. Materials and methods: Data for all relapsed patients treated for OPSCC with definitive (C)RT between 2010 and 2016 were collected. Primary end-point was post-failure survival (PFS). Results: Overall, 273 OPSCC patients completed definitive (C)RT. Of these, 42 cases (n = 26 human papilloma virus (HPV)-negative; n = 16 HPV-positive) had relapsed (n = 23 persistent disease; n = 19 recurrent disease) and were included in the final analysis. Two-year PFS for the entire population was 30.6%; 20.5% for HPV-negative and 43.8% for HPV-positive patients. Salvage curative surgery was associated with a significantly higher 2 years PFS rate (56.2%) compared with palliative treatment (22.9%) and best supportive care (0%) (p < 0.001). A positive trend in 2 years PFS was recorded in the early complete response cases (49.5%) versus patients who did not achieve a complete response within 3 months of the end of (C)RT (23.0%) (p = 0.11). Conclusion: A higher PFS rate is achieved when relapsed OPSCC cases are treated with salvage curative intent. HPV-positive disease and early complete response within 3 months from the end of (C)RT may be related to better PFS.

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